Suspensory Ligament Rehabilitation
- Case Study 2
Suspensory Ligament Rehabilitation
Rehabilitation of Degenerative Suspensory Ligament Desmitis
Patient Profile
Age: 18-year-old
Breed: OTTB
Gender: Mare
Injury: Degenerative Suspensory Ligament Desmitis
Date of Injury: 23.10.2024
Clinical History
This case involved an older thoroughbred mare, a former racehorse, presenting with a cribbing collar and a body condition score (BCS) of 3/9, indicative of significant weight loss.
Findings on Initial Examination:
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Distal Suspensory Branches (Hind Limbs):
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Bilateral swelling noted.
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Left hind: swelling is symmetric.
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Right hind: swelling is more pronounced medially than laterally.
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Left Hind Limb:
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Proximal suspensory thickening observed.
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Marked fetlock hyperextension consistent with chronic suspensory apparatus failure.
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Although a soft angle is present in the right fetlock, the left is significantly more affected.
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Locomotor Assessment:
Due to the high risk of overload and potential for sudden failure under stress, the trotting portion of the examination was kept extremely brief. A right hind lameness score of 3+/5 was noted, which cannot be fully explained by palpation findings. No additional joint or synovial distension, nor soft tissue swelling beyond the suspensory branch involvement, was detected.
Supportive Management Plan:
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Farrier:
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Hind shoes fitted with long plantar extensions using a second shoe welded in reverse to create a “figure-8” configuration.
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Bandaging may have been required to prevent secondary abrasions or lacerations.
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Orthotic Support:
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The EqueStride injury management device was recommended to provide continuous support to both suspensories over the next 2 to 3 months.
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Observations at Time of Device Fitting:
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Moderate swelling present around both hind fetlocks.
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Mare exhibited significant discomfort while standing, frequently shifting weight between limbs.
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Marked difficulty lifting either hind limb from the ground.
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Fetlock hyperextension measured at approximately -20 to -30 degrees.
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Initial reactivity to the support device was noted; however, the owner successfully applied both units under supervision.
Rehabilitation Protocol:
Week 1-5:
Gradual increase in support and duration over a 4 week period, started with 15 minutes/day on Setting 3. Increased up to 2 hours over 4 weeks time and managed to change to a higher setting (level 4) by the end of 4 weeks.
Week 6-12:
Noticeable reduction in swelling, and the mare was less reactive when the device was applied, the horse gained weight and showed less discomfort. Fetlock hyperextension improved by 5 degrees. Further increase in duration with the device on in the highest support setting up to 8 hours/day.
5 Months Post Treatment Progress Report:
The mare began trotting comfortably in the field, demonstrating excellent mobility and overall well-being. She gained weight and showed visible improvement in muscle development.
Fetlock angles appeared normal at rest, with only mild to moderate hyperextension observed during walking, an encouraging sign of improved suspensory function. All previous swelling has fully resolved.
Months 5–7: Tapering Phase
During this period, supportive measures were gradually reduced while closely monitoring for any signs of swelling, discomfort or fetlock hyperextension. The mare remained stable throughout, with no recurrence of clinical signs. Based on her sustained improvement, treatment was successfully concluded at the 7-month mark.